Lifetime alcohol use and overall and cause-specific mortality in the European Prospective Investigation into Cancer and nutrition (EPIC) study.

OBJECTIVES To investigate the role of factors that modulate the association between alcohol and mortality, and to provide estimates of absolute risk of death. DESIGN The European Prospective Investigation into Cancer and nutrition (EPIC). SETTING 23 centres in 10 countries. PARTICIPANTS 380 395 men and women, free of cancer, diabetes, heart attack or stroke at enrolment, followed up for 12.6 years on average. MAIN OUTCOME MEASURES 20 453 fatal events, of which 2053 alcohol-related cancers (ARC, including cancers of upper aerodigestive tract, liver, colorectal and female breast), 4187 cardiovascular diseases/coronary heart disease (CVD/CHD), 856 violent deaths and injuries. Lifetime alcohol use was assessed at recruitment. RESULTS HRs comparing extreme drinkers (≥30 g/day in women and ≥60 g/day in men) to moderate drinkers (0.1-4.9 g/day) were 1.27 (95% CI 1.13 to 1.43) in women and 1.53 (1.39 to 1.68) in men. Strong associations were observed for ARC mortality, in men particularly, and for violent deaths and injuries, in men only. No associations were observed for CVD/CHD mortality among drinkers, whereby HRs were higher in never compared to moderate drinkers. Overall mortality seemed to be more strongly related to beer than wine use, particularly in men. The 10-year risks of overall death for women aged 60 years, drinking more than 30 g/day was 5% and 7%, for never and current smokers, respectively. Corresponding figures in men consuming more than 60 g/day were 11% and 18%, in never and current smokers, respectively. In competing risks analyses, mortality due to CVD/CHD was more pronounced than ARC in men, while CVD/CHD and ARC mortality were of similar magnitude in women. CONCLUSIONS In this large European cohort, alcohol use was positively associated with overall mortality, ARC and violent death and injuries, but marginally to CVD/CHD. Absolute risks of death observed in EPIC suggest that alcohol is an important determinant of total mortality.

Nutrient patterns and their food sources in an International Study Setting: report from the EPIC study.

BACKGROUND Compared to food patterns, nutrient patterns have been rarely used particularly at international level. We studied, in the context of a multi-center study with heterogeneous data, the methodological challenges regarding pattern analyses. METHODOLOGY/PRINCIPAL FINDINGS We identified nutrient patterns from food frequency questionnaires (FFQ) in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study and used 24-hour dietary recall (24-HDR) data to validate and describe the nutrient patterns and their related food sources. Associations between lifestyle factors and the nutrient patterns were also examined. Principal component analysis (PCA) was applied on 23 nutrients derived from country-specific FFQ combining data from all EPIC centers (N = 477,312). Harmonized 24-HDRs available for a representative sample of the EPIC populations (N = 34,436) provided accurate mean group estimates of nutrients and foods by quintiles of pattern scores, presented graphically. An overall PCA combining all data captured a good proportion of the variance explained in each EPIC center. Four nutrient patterns were identified explaining 67% of the total variance: Principle component (PC) 1 was characterized by a high contribution of nutrients from plant food sources and a low contribution of nutrients from animal food sources; PC2 by a high contribution of micro-nutrients and proteins; PC3 was characterized by polyunsaturated fatty acids and vitamin D; PC4 was characterized by calcium, proteins, riboflavin, and phosphorus. The nutrients with high loadings on a particular pattern as derived from country-specific FFQ also showed high deviations in their mean EPIC intakes by quintiles of pattern scores when estimated from 24-HDR. Center and energy intake explained most of the variability in pattern scores. CONCLUSION/SIGNIFICANCE The use of 24-HDR enabled internal validation and facilitated the interpretation of the nutrient patterns derived from FFQs in term of food sources. These outcomes open research opportunities and perspectives of using nutrient patterns in future studies particularly at international level.

Combined impact of healthy lifestyle factors on colorectal cancer: a large European cohort study.

BACKGROUND Excess body weight, physical activity, smoking, alcohol consumption and certain dietary factors are individually related to colorectal cancer (CRC) risk; however, little is known about their joint effects. The aim of this study was to develop a healthy lifestyle index (HLI) composed of five potentially modifiable lifestyle factors - healthy weight, physical activity, non-smoking, limited alcohol consumption and a healthy diet, and to explore the association of this index with CRC incidence using data collected within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. METHODS In the EPIC cohort, a total of 347,237 men and women, 25- to 70-years old, provided dietary and lifestyle information at study baseline (1992 to 2000). Over a median follow-up time of 12 years, 3,759 incident CRC cases were identified. The association between a HLI and CRC risk was evaluated using Cox proportional hazards regression models and population attributable risks (PARs) have been calculated. RESULTS After accounting for study centre, age, sex and education, compared with 0 or 1 healthy lifestyle factors, the hazard ratio (HR) for CRC was 0.87 (95% confidence interval (CI): 0.44 to 0.77) for two factors, 0.79 (95% CI: 0.70 to 0.89) for three factors, 0.66 (95% CI: 0.58 to 0.75) for four factors and 0.63 (95% CI: 0.54 to 0.74) for five factors; P-trend <0.0001. The associations were present for both colon and rectal cancers, HRs, 0.61 (95% CI: 0.50 to 0.74; P for trend <0.0001) for colon cancer and 0.68 (95% CI: 0.53 to 0.88; P-trend <0.0001) for rectal cancer, respectively (P-difference by cancer sub-site = 0.10). Overall, 16% of the new CRC cases (22% in men and 11% in women) were attributable to not adhering to a combination of all five healthy lifestyle behaviours included in the index. CONCLUSIONS Combined lifestyle factors are associated with a lower incidence of CRC in European populations characterized by western lifestyles. Prevention strategies considering complex targeting of multiple lifestyle factors may provide practical means for improved CRC prevention.

Metabolomic profiles of hepatocellular carcinoma in a European prospective cohort.

BACKGROUND Hepatocellular carcinoma (HCC), the most prevalent form of liver cancer, is difficult to diagnose and has limited treatment options with a low survival rate. Aside from a few key risk factors, such as hepatitis, high alcohol consumption, smoking, obesity, and diabetes, there is incomplete etiologic understanding of the disease and little progress in identification of early risk biomarkers. METHODS To address these aspects, an untargeted nuclear magnetic resonance metabolomic approach was applied to pre-diagnostic serum samples obtained from first incident, primary HCC cases (n = 114) and matched controls (n = 222) identified from amongst the participants of a large European prospective cohort. RESULTS A metabolic pattern associated with HCC risk comprised of perturbations in fatty acid oxidation and amino acid, lipid, and carbohydrate metabolism was observed. Sixteen metabolites of either endogenous or exogenous origin were found to be significantly associated with HCC risk. The influence of hepatitis infection and potential liver damage was assessed, and further analyses were made to distinguish patterns of early or later diagnosis. CONCLUSION Our results show clear metabolic alterations from early stages of HCC development with application for better etiologic understanding, prevention, and early detection of this increasingly common cancer.

Government Spending and Re-election

Does additional government spending improve the electoral chances of incumbent political parties? This paper provides the first quasi-experimental evidence on this question. Our research design exploits discontinuities in federal funding to local governments in Brazil around several population cutoffs over the period 1982-1985. We find that extra fiscal transfers resulted in a 20% increase in local government spending per capita, and an increase of about 10 percentage points in the re-election probability of local incumbent parties. We also find positive effects of the government spending on education outcomes and earnings, which we interpret as indirect evidence of public service improvements. Together, our results provide evidence that electoral rewards encourage incumbents to spend part of additional revenues on public services valued by voters, a finding in line with agency models of electoral accountability.

Girls’ Education: Keeping Girls in School. ( A Literature Review with Implications for Girls’ School Attendence in Cape Verde)

Education plays a very important role in society’s development in order to promote good citizenship and individual rights and freedom. To this end, it is fundamental that girls be included in the education process. Inmost developed and developing countries, theoretically, both males and females have access to education. Cape Verde is no exception; however, the reality is that even in Cape Verde, promoting girls’ education and creating conditions to motivate girls to stay in school remains a challenge. Whereas girls have access to education many girls drop out for gender-related reasons. This paper will investigate girls’ education initiatives in general, and Cape Verde specific to offer recommendations and strategies to keep girls in school.

Government spending and re-election: Quasi-experimental evidence from Brazilian municipalities

Does additional government spending improve the electoral chances of incumbent politicalparties? This paper provides the first quasi-experimental evidence on this question. Our researchdesign exploits discontinuities in federal funding to local governments in Brazil around severalpopulation cutoffs over the period 1982-1985. We show that extra fiscal transfers resulted in a20% increase in local government spending per capita, and an increase of about 10 percentagepoints in the re-election probability of local incumbent parties. In the context of an agency modelof electoral accountability, as well as existing results indicating that the revenue jumps studiedhere had positive impacts on education outcomes and earnings, these results suggest that expectedelectoral rewards encouraged incumbents to spend additional funds in ways that were valued byvoters.

Education, growth and income inequality

Estimates of the e¤ect of education on GDP (the social return to education)have been hard to reconcile with micro evidence on the private return. We present a simple explanation that combines two ideas: imperfect substitution between worker types and endogenous skill biased technological progress. When types of workers are imperfect substitutes, the supply of human capital is negatively related to its return, and a higher education level compresses wage di¤erentials. We use cross-country panel data on income inequality to estimate the private return and GDP data to estimate the social return. The results show that the private return falls by 2 percentage points when the average education level increases by a year, which is consistent with Katz and Murphy's [1992] estimate of the elasticity of substitution between worker types. We find no evidence for dynamics in the private return, and certainly not for a reversal of the negative e¤ect as described in Acemoglu [2002]. The short run social return equals the private return.

Correlates of frailty, prediction of functional decline and preventative approaches - selected results from the lausanne cohort 65+ (lc65+) study (Switzerland) (Lausanne) and the longitudinal urban cohort ageing study (Lucas) (Germany)

Overall introduction.- Longitudinal studies have been designed to investigate prospectively, from their beginning, the pathway leading from health to frailty and to disability. Knowledge about determinants of healthy ageing and health behaviour (resources) as well as risks of functional decline is required to propose appropriate preventative interventions. The functional status in older people is important considering clinical outcome in general, healthcare need and mortality. Part I.- Results and interventions from lucas (longitudinal urban cohort ageing study). Authors.- J. Anders, U. Dapp, L. Neumann, F. Pröfener, C. Minder, S. Golgert, A. Daubmann, K. Wegscheider,. W. von Renteln-Kruse Methods.- The LUCAS core project is a longitudinal cohort of urban community-dwelling people 60 years and older, recruited in 2000/2001. Further LUCAS projects are cross-sectional comparative and interventional studies (RCT). Results.- The emphasis will be on geriatric medical care in a population-based approach, discussing different forms of access, too. (Dapp et al. BMC Geriatrics 2012, 12:35; http://www.biomedcentral.com/1471-2318/12/35): - longitudinal data from the LUCAS urban cohort (n = 3.326) will be presented covering 10 years of observation, including the prediction of functional decline, need of nursing care, and mortality by using a self-filling screening tool; - interventions to prevent functional decline do focus on first (pre-clinical) signs of pre-frailty before entering the frailty-cascade ("Active Health Promotion in Old Age", "geriatric mobility centre") or disability ("home visits"). Conclusions.- The LUCAS research consortium was established to study particular aspects of functional competence, its changes with ageing, to detect pre-clinical signs of functional decline, and to address questions on how to maintain functional competence and to prevent adverse outcome in different settings. The multidimensional data base allows the exploration of several further questions. Gait performance was exmined by GAITRite®-System. Supported by the Federal Ministry for Education and Research (BMBF Funding No. 01ET1002A). Part II.- Selected results from the lausanne cohort 65+ (Lc65 + ) Study (Switzerland). Authors.- Prof Santos-Eggimann Brigitte, Dr Seematter-Bagnoud Laurence, Prof Büla Christophe, Dr Rochat Stéphane. Methods.- The Lc65+ cohort was launched in 2004 with the random selection of 3054 eligible individuals aged 65 to 70 (birth year 1934-1938) in the non-institutionalized population of Lausanne (Switzerland). Results.- Information is collected about life course social and health-related events, socio-economics, medical and psychosocial dimensions, lifestyle habits, limitations in activities of daily living, mobility impairments, and falls. Gait performance are objectively measured using body-fixed sensors. Frailty is assessed using Fried's frailty phenotype. Follow-up consists in annual self-completed questionnaires, as well as physical examination and physical and mental performance tests every three years. - Lausanne cohort 65+ (Lc65 + ): design and longitudinal outcomes. The baseline data collection was completed among 1422 participants in 2004-2005 through self-completed questionnaires, face-to-face interviews, physical examination and tests of mental and physical performances. Information about institutionalization, self-reported health services utilization, and death is also assessed. An additional random sample (n = 1525) of 65-70 years old subjects was recruited in 2009 (birth year 1939-1943). - lecture no 4: alcohol intake and gait parameters: prevalent and longitudinal association in the Lc65+ study. The association between alcohol intake and gait performance was investigated.

Statewide Transportation Improvement Program 2010-2013

Iowa’s Statewide Transportation Improvement Program (STIP) has been developed in conformance with the guidelines prescribed by 23 USC. The STIP is generated to provide the Federal Highway Administration (FHWA) and Federal Transit Administration (FTA) a listing of all projects that are candidates for federal aid from the FHWA and FTA for four federal fiscal years (FFY). Preceding the listings of federal-aid candidates are general comments concerning Iowa’s public participation process for selection of federal-aid projects and the basis for funding the proposed projects. Documents evidencing the Iowa Department of Transportation’s (Iowa DOT) authority to act concerning matters related to transportation, federal-aid expenditures and approvals of Metropolitan Planning Organizations’ (MPOs) Transportation Improvements Programs (TIPs) have been provided in past STIP’s and can be provided again upon request. The projects identified within the 2010-2013 STIP are divided into two groups. Projects proposed for funding from FHWA programs are shown first. FTA programs follow. Maps are included that identify locations of Iowa DOT District Planners, Metropolitan Planning Organizations (MPOs), Regional Planning affiliations (RPAs), and transit systems.

A Computerized Method for the Hydrologic Design of Culverts, February 1974

Nationwide, about five cents of each highway construction dollar is spent on culverts. In Iowa, average annual construction costs on the interstate, primary, and federal-aid secondary systems are about $120,000,000. Assuming the national figure applies to Iowa, about $6,000,000 are spent on culvert construction annually. For each one percent reduction in overall culvert costs, annual construction costs would be reduced by $60,000. One area of potential cost reduction lies in the sizing of the culvert. Determining the flow area and hydraulic capacity is accomplished in the initial design of the culvert. The normal design sequence is accomplished in two parts. The hydrologic portion consists of the determination of a design discharge in cubic feet per second using one of several available methods. This discharge is then used directly in the hydraulic portion of the design to determine the proper type, size, and shape of culvert to be used, based on various site and design restrictions. More refined hydrologic analyses, including rainfall-runoff analysis, flood hydrograph development, and streamflow routing techniques, are not pursued in the existing design procedure used by most county and state highway engineers.

Fertility discourse in parental leave policies' media coverage : a frame analysis of French-speaking Swiss press articles from 1999 to 2009

This paper analyses the media coverage of parental leave policies (parental and paternity leaves) in Swiss French-speaking press articles from 1999 to 2009. Switzerland is one of the rare European countries which has no statutory parental or paternity leave. The aim is to describe the mediatisation of these policies and to analyse the arguments in favour and against their implementation. We investigate the status of a fertility frame - the mobilisation of discourse relating to fertility issues - among the various arguments used to justify or reject parental leave policies. We proceed with a content analysis of 579 press articles, as well as a frame analysis on a subset in which parental leave policies are the central theme (N=206). Results show that paternity leave is the predominant public issue addressed in the dataset. A mediatisation peak was reached in 2007, following an initiative of a member of the Federal executive to implement a short paternity leave. Parental leave policies are predominantly represented in a positive light. The main positive frame is economic, in which leaves are represented as serving the interests of companies. Involved fatherhood and gender equality are also frequently mentioned as positive frames. The fertility frame is only moderately used in articles covering Swiss news on paternity leaves. Conversely, the fertility frame is largely mobilised in articles covering parental leave in other countries. We discuss some interpretations of this discrepancy and suggest future avenues of research on parental leave policies in Switzerland.

Iowa Communications Network - Fiscal Year 2012 Annual Report

The Iowa Communications Network (ICN) is the country’s premier distance learning and state government Network, committed to providing Iowans with convenient, equal access to education, government and healthcare. The Network makes it possible for Iowans, physically separated by location, to interact in an efficient, creative, and cost-effective manner. ICN provides high-speed Internet, data, video conferencing, and voice (phone) services to authorized users, under Code of Iowa, which includes: K-12 schools, higher education, hospitals, state and federal government, National Guard armories, and libraries.

Engineering Study Automating Iowa's Speed Monitoring Program, HR-228, 1983

Excessive speed on State and County highways is recognized as a serious problem by many Iowans. Speed increases both the risk and severity of accidents. Studies conducted by the FHWA and NHTSA have concluded that if average speeds were increased by five MPH, fatalities would increase by at least 2,200 annually. Along with the safety problems associated with excessive speed are important energy considerations. When the national speed limit was lowered to 55 MPH in 1974, a tremendous savings in fuel was realized. The estimated actual savings for automobiles amounted to 2.2 billion gallons, an average of 20.75 gallons for each of the 106 million automobiles registered in 1975. These benefits prompted the Federal-Aid Amendment of 1974 requiring annual State enforcement certification as a prerequisite for approval of Federal-aid highway projects. In 1978, the United States D.O.T. recommended to Congress significant changes in speed limit legislation designed to increase compliance with the national speed limit. The Highway Safety Act of 1978 provides for both withholding Federal-aid highway funds and awarding incentive grants based on speed compliance data submitted annually. The objective of this study was to develop and make operational, an automatic speed monitoring system which would have flexible capabilities of collecting accurate speed data on all road systems in Iowa. It was concluded that the Automatic Speed Monitoring Program in Iowa has been successful and needed data is being collected in the most economical manner possible.

Feasibility of Using Automated Distress Data in the County Need Study, TR-418, 1998

The purpose of this project was to determine the feasibility of using pavement condition data collected for the Iowa Pavement Management Program (IPMP) as input to the Iowa Quadrennial Need Study. The need study, conducted by the Iowa Department of Transportation (Iowa DOT) every four years, currently uses manually collected highway infrastructure condition data (roughness, rutting, cracking, etc.). Because of the Iowa DOT's 10-year data collection cycles, condition data for a given highway segment may be up to 10 years old. In some cases, the need study process has resulted in wide fluctuations in funding allocated to individual Iowa counties from one study to the next. This volatility in funding levels makes it difficult for county engineers to plan and program road maintenance and improvements. One possible remedy is to input more current and less subjective infrastructure condition data. The IPMP was initially developed to satisfy the Intermodal Surface Transportation Efficiency Act (ISTEA) requirement that federal-aid-eligible highways be managed through a pavement management system. Currently all metropolitan planning organizations (MPOs) in Iowa and 15 of Iowa's 18 RPAs participate in the IPMP. The core of this program is a statewide data base of pavement condition and construction history information. The pavement data are collected by machine in two-year cycles. Using pilot areas, researchers examined the implications of using the automated data collected for the IPMP as input to the need study computer program, HWYNEEDS. The results show that using the IPMP automated data in HWYNEEDS is feasible and beneficial, resulting in less volatility in the level of total need between successive quadrennial need studies. In other words, the more current the data, the smaller the shift in total need.